Would you be brave enough to tell a nurse she's fat? One of our most senior nurses says you should - as she admits her own weight hit 18 stone

At 5ft 6ins tall, weighing 18st 1lb she admits she felt like a hypocrite

She says causes of obesity are complicated but work-life balance can be blamed

1 in 4 nurses in England are obese, levels are higher than in doctors and dentists

Fiona and two other nurses shared how they managed to reach a healthy weight

The irony was inescapable. As one of Britain's four chief nursing officers, I was responsible for drawing up policy on how best to tackle the growing problem of obesity and yet I was clearly losing my own battle with the bulge.

Being fat has become so normalised that no one at work ever said anything critical, even though in my mid 50s I was 7st overweight and chronically unfit. Now, I feel ashamed that I was doing such a job when I was so overweight myself.

But my experience has taught me just how much we tiptoe around the subject of obesity. My family kept their opinions to themselves, too. It was only once it became clear to my two daughters Emma and Anna, then 17 and 15, that I was really serious about slimming down that they confessed how worried they'd been about me being so fat.

'Fat' is a horrible, uncompromising word, but sometimes it's the one word people need to hear, yet no one dares utter it. It's understandable not to want to hurt people's feelings, but I think we're reaching a point where we simply can't do that any more.

Fiona McQueen (pictured before) felt the urge to lose weight at age 56. She says she felt like a hypocrite advising others how to lose weight whilst being 7st overweight

As a nurse, I was setting a really bad example not only to my colleagues and patients, but to my children, too. How could I expect others to heed my advice when I didn't myself?

The causes of obesity are complicated — and often deeply personal. But there's no denying the fact that overweight NHS staff are more likely to hinder rather than help the growing obesity crisis.

One in four nurses in England are obese, the levels are higher in my profession than among doctors and dentists. In Scotland it's even worse, with seven in ten nurses overweight and three in ten obese, according to research.

Tameside Hospital in Greater Manchester recently became the first to ban sugar from its staff canteen — and saw many workers lose weight. The Royal College of Nursing has even launched an app designed to help nurses lose weight.

Obesity is not a sign of laziness. Most of the overweight nurses I know are compassionate workaholics — it's their work-life balance that's the problem.

Nightshifts mess around with your body clock and appetite. And it makes matters harder still when hospitals do not provide adequate healthy eating options. It's all too easy to opt for a calorie-laden snack when you're feeling tired and hungry.

Like many obese people, I hated what I saw in the mirror. At 5ft 6in tall, I weighed 18st 1lb and my BMI was a whopping 41 (the healthy range being 18.5 to 24.9). Not to sugarcoat it, I was morbidly obese. I was mortified by my size and felt like a hypocrite. I had aching joints, I was always tired and lacking energy.

But bad eating habits can be hard to break, particularly at work. There were some healthy elements in my diet, but grabbing unhealthy snacks on the go was my downfall.

Fiona McQueen (pictured after) recalls being heavier than all of her friends throughout her childhood years and says she gained further weight after becoming a mother

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I'd be up at 4.45am and start the day with buttered toast or cereal. By the time I got to work in Edinburgh, as Scotland's chief nursing officer, I'd be hungry again and eat a sugary treat, like a scone.

Lunch would be something portable at my desk or on the way to a meeting, usually a sandwich and crisps. And by 4pm I'd be starving again after hours on my feet, and eat more crisps or share tea and biscuits in the staff dining room.

At meetings, I'd take cake and biscuits when they were offered to stave off hunger pangs until dinner — a pizza or ready meal. Often I'd finish a long day with a treat of cake.

I yo-yo dieted over the years — losing 5st on two occasions, only to pile it all back on. What I never did was tackle my relationship with food, so I was bound to fail.

It wasn't until October 2016 that something clicked. I looked at myself and said: 'You're fat, Fiona.' Fat — it was the truth and I needed to hear it.

I looked at myself and said: 'I'm fat.' It's a horrible word but it was the truth and I needed to hear it

Aged 56, it struck me I would die early if I didn't do something. Through work I was all too aware that obesity is linked to strokes, heart attacks, cancer, early onset dementia and diabetes.

This time I was strict. I decided no fads, no promising myself I'd start tomorrow, no fooling myself I could lose weight and go back to eating the same old things.

I realised my issues harked back to childhood. When I was 11 I needed a hip operation because my thigh wasn't growing properly. During the six weeks of bed rest that followed, treats came thick and fast, and I piled on weight.

Throughout my teenage years I was convinced I was heavier than all my friends. When I married my husband Bob — we were 22 and 23 respectively — I was reasonably happy with my appearance, but it quickly went downhill from then on.

I qualified as a nurse at 22, and was soon working long days with early starts, constantly changing shifts and new demands every day that prevented me from building a healthy routine.

Ellie Backhurst, 40, (pictured) says she feels embarrassed over her weight and has begun bringing healthy meals to work to lose weight

There's also a social element to unhealthy snacks — our society has come to use them as a reward. We say, 'Let's have something sweet, we deserve it.'

You might think nurses, who spend so much time on their feet, would work off the calories, but given the statistics it clearly doesn't work that way.

At 27, I became an assistant director of nursing and my schedule became even more varied and hectic so I would constantly be grabbing something on the hoof.

Like many women, becoming a mum 24 years ago triggered further weight gain. I was back at work full-time nine weeks after having my eldest son, with my husband working as a social worker. Although I was breastfeeding, which can help to maintain a healthy weight, motherhood left me with even less time to buy and cook healthy meals. My junk food habit got worse as my two daughters arrived over the next few years.

As most mums know, the demands of making sure your children are properly nourished and getting everything they need — from homework to afterschool clubs — can take up all your time. You put their needs first, and have little energy left over to worry about yourself.

I got caught up in an endless cycle of gaining weight, losing it and re-gaining it.

Although I cooked some healthy meals, I also resorted to 'quick fixes' like ready-meals and take-aways. We ate too much at meal times and had a sweetie drawer.

As for how I felt about my expanding waistline, I didn't spend a huge amount of time thinking about it. Having always struggled with body image, I felt the best I could hope for was to look reasonably 'smart'.

Perhaps because I have daughters, I've always felt uncomfortable about society's perception of beauty — you don't have to be slim to be attractive.

But I would say that, since losing weight, I'm more comfortable in my own skin. It's important to be healthy, not obese.

Laura Howell, 32, (pictured before left and after right) was able to lose 4st after being referred by her GP for reduced gym fees

To fight this fight, it's important to show understanding towards people who are overweight, but I also think as a society we've normalised obesity. It was as plain as the nose on anyone's face that I was obese, but for the most part, no one said anything.

Once, when I'd lost some weight, a colleague and friend did say: 'I'm so pleased — you were beginning to waddle.' She struggles with her weight, too, and it was said supportively so we had a good laugh about it. Now, I feel it's crucial to be a good role model.

Losing 7st 5lb wasn't easy. I reduced my calories to 1,500 a day and gave up refined sugars and processed foods.

These days I eat porridge and fruit for breakfast, homemade soup for lunch, and cook healthy chillies or curries for the evening — I make them ahead and freeze them in batches. I'm not a good cook, but I have learned to pay attention to the quality of food.

Getting active was also important and I now walk everywhere.

Everyone has bad days and when that happened in the early days, I learned to recognise that it wasn't the end of the world.

There's always that temptation to go overboard and eat everything in sight once you've broken the seal. But thankfully that rarely happened and the satisfaction I got in watching my weight drop soon outweighed the pleasure of a sweet treat.

Fiona McQueen (pictured centre with her daughters) says she believes fatty foods should be treated in the same way as cigarettes

Now at work, I say no to snacks, even if a colleague has baked something special. Instead I bring in fruit and cut vegetables, such as carrots, peppers or tomatoes.

Strangely, you can feel under pressure to take a sweet treat — they're seen as a reward, and people can get defensive about their own eating habits if you say no. Nobody likes it when you hold a mirror up to their own behaviour.

But I believe we must treat fatty foods in the same way as cigarettes. We would never say that anyone, particularly a child, 'deserves a cigarette' yet we reward ourselves and our children with unhealthy treats and junk food.

These days, no food is banned in our house. I'm happy to buy biscuits or cakes if the kids want some, but I'll buy one packet while I'm out walking, instead of keeping a stash in the house. And when it's gone, it's gone.

I now weigh 10st 10lb — a healthy weight for my height. But the impact of what I've done only really hit home when I was sitting talking to my daughters one day about how much better I felt.

They both looked at each other before saying in unison: 'We're so relieved, Mum.'

Fiona McQueen (pictured before her weightloss with her daughter and husband) says she feels more confident at work since losing weight

It was only then that they told me how worried they'd been about my weight and I felt so bad that I'd piled all this anxiety on their young shoulders. Now, I want to shout from the rooftops how wonderful it feels to no longer be imprisoned in an obese body.

For so long I hid as much of myself as I could in stretchy dresses. But these days I've even borrowed tops from my daughters and we often go

shopping together, which is really nice as before I just felt like an embarrassment.

I also feel so much more confident at work. The big question for me now is how do I support other obese nurses in dealing with their weight issues.

We need to be bold and ambitious as we look at our diet and obesity strategy and take firm action because we simply cannot go on like this, with the problem constantly worsening.

At last I can be a committed, convincing voice on how to tackle obesity. I can be proud of who I am.

It's hard to be healthy when you work in the NHS

Ellie Backhurst, 40 (pictured above), is a trainee associate ambulance practitioner (one step down from a paramedic). She lives in Woking, Surrey, with her husband and two children, aged 13 and eight. She says:

I've always been a comfort eater but working night shifts doesn't help. At 1am, when your energy is flagging, it's all too easy to grab a quick sugar hit and I've noticed that if I'm upset or if I've been to a particularly traumatic incident, I reach for more chocolate.

Patients can be rude. There's a certain generation who speak their minds and don't care if they hurt your feelings. I've had people say I won't fit in their room and that I'm fat.

Ellie Backhurst, 40, (pictured) revealed she was reduced to tears at work after a patient made a comment about her weight

Several months ago, the wife of a patient I'd made a sandwich for — because his blood sugar was low — said: 'Well you don't need a sandwich do you?' I actually cried.

I know I'm overweight. I am ashamed and embarrassed about it. I don't want to be the 'fat mum' for my children and because I'm often having to see patients who have problems as a result of their obesity — such as diabetes — I should be setting a better example.

So I'm doing something about it. I joined WeightWatchers a year ago and I've lost a stone.

My target weight is 10st and I'm determined to get there. I've started preparing healthy meals to take into work and I snack on fruit instead of biscuits and chocolate.

I've never felt any pressure from colleagues to lose the weight, but I constantly feel tired. I know losing weight will help this.